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[Pharmaceutical Verification of Chemotherapy-induced Adverse Events]

Yoshitaka Saito1

  • 1Department of Clinical Pharmaceutics & Therapeutics, Faculty of Pharmaceutical Sciences, Hokkaido University of Science.

Yakugaku Zasshi : Journal of the Pharmaceutical Society of Japan
|August 3, 2026
PubMed

Insights

Managing cancer treatment side effects is key. This study found liver metastasis increases skin toxicity risk with anti-EGFR therapy and renal impairment worsens neutropenia with chemotherapy, highlighting areas for improved patient care.

Area of Science:

  • Oncology
  • Pharmacology
  • Clinical Pharmacy

Background:

  • Optimizing cancer treatment and patient satisfaction requires effective management of adverse events.
  • Studies have investigated anti-epidermal growth factor receptor (EGFR) toxicities, neutropenia in renal impairment (RI), and pharmaceutical care for immune checkpoint inhibitors (ICIs).

Purpose of the Study:

  • To identify risk and preventive factors for skin toxicities in anti-EGFR therapy for metastatic colorectal cancer (mCRC).
  • To assess the impact of RI on severe neutropenia development in patients receiving trifluridine/tipiracil (FTD/TPI) and carboplatin+pemetrexed chemotherapy.
  • To evaluate the role of pharmaceutical care in optimizing outpatient ICI treatment.

Main Methods:

  • Retrospective analysis of patients with mCRC undergoing anti-EGFR treatment to identify skin toxicity risk factors.
  • Analysis of neutropenia development in patients with RI receiving FTD/TPI or carboplatin+pemetrexed chemotherapy.
  • Assessment of pharmaceutical interventions in patients receiving ICIs.

Main Results:

  • Liver metastasis was a risk factor for grade ≥2 skin toxicities in anti-EGFR therapy; preemptive antibiotics showed preventive effects.
  • Topical steroids with minocycline prevented grade ≥2 rashes but not overall skin toxicities.
  • Patients with RI had significantly higher early and overall severe neutropenia with FTD/TPI and carboplatin+pemetrexed chemotherapy.
  • Pharmaceutical care may improve outpatient ICI treatment quality, with early intervention being crucial.

Conclusions:

  • Clinically important outcomes were identified to support less burdensome chemotherapy regimens.
  • Findings emphasize the need for tailored management of toxicities based on patient factors like RI and specific cancer types.
  • Proactive pharmaceutical interventions are vital for enhancing cancer treatment outcomes and patient safety.
Keywords:
anti-epidermal growth factor receptor (EGFR) monoclonal antibodyimmune checkpoint inhibitorpharmaceutical carerenal impairmentrenally excreted anticancer drugskin toxicity

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